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F0605
D

PRN Psychotropic Medication Ordered Without Required 14-Day Stop Date

Fort Worth, Texas Survey Completed on 12-04-2025

Penalty

No penalty information released
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The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.

Summary

A deficiency occurred when a resident was prescribed a PRN psychotropic medication, Alprazolam, for anxiety without a required 14-day stop date. The medication order was initiated upon the resident's readmission from the hospital and entered into the facility's system without specifying a stop date, as required by facility policy and regulatory guidelines. The resident's care plan did not reflect the use of this anti-anxiety medication, and medication administration records showed that the resident had not received any doses of the PRN Alprazolam during the review period. Interviews with nursing staff and the Director of Nursing (DON) confirmed that all PRN psychotropic medications must have a 14-day stop date to allow for reassessment and reevaluation of the medication's appropriateness. The admitting nurse did not ensure the stop date was included, and subsequent checks by the DON and ADON did not identify the omission. The facility's policy clearly stated the requirement for a 14-day limitation on PRN psychotropic orders unless specifically extended by the prescriber, but this was not followed in this instance.

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